I-Bi-Level Positive Pressure Versus ne-CPAP
I-Bi-level ingcindezi yomoya ohamba phambili (BiPAP) uhlobo lokungenisa umoya okungavumelekile okusiza ukugcina umoya ophezulu wamapayipi uvule ngokunikeza ukugeleza komoya okwenziwe ngombukiso wesimo. Umoya ucindezelwa umshini, owubeka emasikini ebusweni ngokusebenzisa isikhathi eside, ipulasitiki ukuxosha.
Ukuqonda i-BiPAP
I-BiPAP iyisidingo esinikeza ukulethwa komoya ocindezelweyo kusuka kudivayisi ye-tabletop, ngokusebenzisa ubuso obuso bokusekela ukuphefumula.
Ngandlela-thile, kufana ne-CPAP, kodwa nge-BiPAP, udokotela ubeka izingcindezi ezithile ezihlukile: Ukucindezela okuphakeme kusetshenziselwa ukuphefumula (okubizwa ngokuthi ukugqugquzela ukucindezela umoya, noma i-IPAP) kanye nokucindezela okuphansi okusetshenziselwa ukuphefumula ( kubizwa ngokuthi ukuphefumula okuhle komphefumulo womoya, noma i-EPAP).
Indlela i-BiPAP isiza ngayo nge-COPD
Abantu abane-COPD banenkinga yokuphefumula, okuvame ukubi kakhulu ebusuku. Ebusuku, imisipha ye-throat ebuthakathaka kakade kubantu abaneCOPD ingawa, ibuhlungu kakhulu ukuvinjelwa kwamabhomu okwenzekayo nalesi sifo. Uma lokhu kwenzeka, kungaba nzima iziguli ukugcina imimoya yabo ivulekile ngokwanele ukuze kugcinwe amazinga e-oxygen saturation , futhi ngesikhathi esifanayo bagcine amazinga abo e-carbon dioxide egazini lawo phansi (gwema ukuxoshwa kwegazi.) I-BiPAP ingasiza ngalokhu ngokuletha umoya ocindezelayo njalo ngokusebenzisa i-mask eyanciphisa umsebenzi okumelwe wenziwe ngokushintshaniswa okwanele kwegesi oksijini kanye ne-carbon dioxide okumele kwenzeke ku- alveoli .
Kucatshangwa ukuthi i-BiPAP ingase isize nangokuvumela ukuvele kubuthakathaka imisipha yokuphefumula ukuphumula isikhathi esithile ebusuku.
I-BiPAP vs i-CPAP
Kwabaguli be-COPD, i-BiPAP iyindlela yokukhetha yokwelashwa nge- CPAP (ukucindezela okuqhubekayo kwe-airway) ngoba kulula ukuthi lezi ziguli zikhishwe ngokucindezela okuphansi.
Kungaba nzima kunoma yikuphi ukukhipha ukucindezela (yingakho ngezinye izikhathi i-BiPAP isetshenziselwa esikhundleni se-CPAP ye-apnea yokulala), kodwa lokhu kungaba nzima nakakhulu nge-COPD, lapho ukuphefumula kuyinkinga kunokuba inhalation. I-BiPAP ibuye ivumele ukulungiswa ngesikhathi, okuyinto ewusizo kakhulu kulabo abane-COPD lapho kuphuma khona ukuphumula.
Uma Isetshenziswa Nge-COPD
Kunezilungiselelo eziningana lapho i-BiPAP ingasetshenziselwa abantu abane-COPD. Lokhu kufaka:
- Ngehluleka ukuphefumula okuphefumulayo (ukuhluleka kokuphefumulela uhlobo II lapho uphawu oluyinhloko lugcinwa khona nge-carbon dioxide) njengenye indlela yokuphuza umoya.
- Kubantu abanomdlandla obunomthelela obuthakathaka obunzima (umoya wokuphefumula), i-tachypnea (ukuphefumula okusheshayo kodwa okungajulile), ukwanda kwamazinga e-carbon dioxide egazini (hypercapnia) negazi pH lika-7.25 kuya ku-7.35 .
Izinzuzo ze-BiPAP
Ukusetshenziswa kwe-BiPAP, uma kukhonjisiwe, kunganciphisa inani le-COPD lokulimaza okuhlangenwe nakho komunye umuntu, futhi kunganciphisa isidingo sokungena umoya (ukusekelwa kwephefumula). I-BiPAP ingenza umehluko empilweni yokuphila futhi itholakale ngokunciphisa kakhulu ingozi yokufa lesi sifo.
Ukuqapha kanye nezinkinga
Ukusetshenziswa kwe-ventilation engavumelekile ku-COPD kusesezinyathelo zokuqala zokuhlolwa ngezindlela eziningi, futhi indima yayo ngqo yeziguli ezine-COPD isacacisiwe.
Nakuba kungase kube usizo kakhulu kwabanye abantu abanesifo, akusizi wonke umuntu. Ngesikhathi samanje, akufanele isetshenziswe kubantu abanokuzethemba emithi, njengalabo abanesifo segazi esincane noma izifo ezimbi. Iziguli ezine-acidosis enamandla (igazi eliphansi PH) nalabo abanesifo senhliziyo esisheshayo ikakhulukazi, kubonakala bengenzi kahle ngalolu cwaningo.
> Imithombo:
> Ankaergaard, K., Tonnesen, P., Laursen, L. et al. Ukwelashwa kwe-Non-Vasive Ventilation (NIV) ye-COPD Iziguli ezine-History of Exacerbation-Treated Exacerbation; Isifundo Esingahleliwe, Esilawulwayo, Esiphakathi Kakhulu. Imithi yokwelapha ye-BMC . 2016. 16 (1): 32.
> Duiverman, M., Windisch, W., Storre, J., noP. Wijkstra. Indima ye-NIV e-Chronic Hypercapnic COPD Ukulandela Ukukhulisa Okumangalisayo: Ukubaluleka kokukhethwa kwesineke. Ukuthuthukiswa Kwezokwelapha Emzimbeni Wokuphefumula . 2016. 10 (2): 149-57.
> I-Gay, i-P. I-Nocturnal Ventilatory Support ku-COPD. Kusesikhathini.
> Ko, B., Ahn, S., Lim, K. et al. Ukwehluleka Kwangaphambi Kokungenwa Kwemvelo Okungavamile Ukugula Kwamapululini Okungavimbayo Ngokwehluleka Kokuphefumula Ngokuphefumula Kwe-Hypercapnic. Imithi yangaphakathi neyiphuthumayo . 2015. 10 (7): 855-60.